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Risks associated with mortality in VEXAS
Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic syndrome (VEXAS) took the centre stage when it was first introduced at ACR20 last year. It got everyone’s thinking that they might have encountered one or two patients in their rheumatology lifetime who might have this condition.
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Telemedicine Enriched Care Model for Autoinflammatory Diseases
Traditionally telemedicine is thought to be a technology where a patient directly talks to a provider or a specialist; however, another concept of having a patient with a local primary care who in turn accesses specialists via video conferencing, is gaining some momentum.
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Racial disparities & Co-morbidities in PsA findings. Amongst important others, increased biologic use in Caucasians w/ PsA vs DMARDs in black PsA pts. View Abs 1780 for other relevant findings. #ACR21 #RheumNow #ACRbest @RheumNow https://t.co/0uKsa8i0bG https://t.co/R9YkxYqXws
Dr. Rachel Tate uptoTate ( View Tweet)
👉29% of pts on RTX fail to mount a humoral OR cellular response to #COVIDvaccine & have⬆️hosp,⬆️hosp stay,⬆️severity, persistent viremia,⬆️deaths)
👉study adding booster (AZ or mRNA) overcomes this, enhancing humoral and cellular response
#ACR21 @rheumnow Abst#L17 https://t.co/yuX1TT6ZBF
TheDaoIndex KDAO2011 ( View Tweet)
Work participation in patients with axSPA
Patients w/ axSpA often have increased absence from work as well as reduced productivity at work, which can lead to wider economic & social burden.
Dr. Dey (@DrMiniDey) discusses abstracts from #ACR21.
https://t.co/eAMLPR2zoT https://t.co/NuIajGa7gx
Links:
Dr. John Cush RheumNow ( View Tweet)
Methotrexate did not improve Ustekinumab efficacy in tx of PsA
⭐️Addition of MTX did not improve dactylitis, enthesitis, skin, QoL or function
#ACR21 #ACRBest @RheumNow
Abs#L12
https://t.co/6dxWPNskou https://t.co/BnzH8PfaMV
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
Very interesting talk Abst L16
Singh & colleagues found that patients with rheumatic diseases are at increased risk for breakthrough infxn
- Recent drug exposure and certain medication type can influence outcomes
- Findings support need for 3rd dose in RD pts
#ACR21 @RheumNow https://t.co/vU6ZNIEWbc
Akhil Sood MD AkhilSoodMD ( View Tweet)
Prevalent drug utilization unrelated to enthesitis in PsA. Pts on cDMARDs had higher physician globals vs those treated w/TNFi & IL-17i. In aggregate, no pattern of dz activity scores correlation w/drugs. Abs 1782 #ACR21 #RheumNow @RheumNow @doctorRBC https://t.co/x57BkBjpjo https://t.co/QmdXqOxLki
Dr. Rachel Tate uptoTate ( View Tweet)
Phase 2 trial of tildrakizumab (IL-23i) for the treatment of PsA showed lower efficacy in pts with metabolic syndrome compared to those without
#ACR21 @RheumNow
Abs#1819
https://t.co/GYHbiH9NSW https://t.co/YGcZcITjzj
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
USA EMR (N3C) Data on 577,335 Rheum Pts w/18,164 #COVID19 breakthrough infx (BTI)
👉91% vax'd
👉3.1% w/BTI
👉86% were vax'd May 2021 or earlier
👉More BTI w/Pfizer
👉BTI higher in inflamm myositis, RA
👉Drugs assc w/BTI: biologics, mult DMARDs
#ACR21 @rheumnow Abst#L16 #ACRbest https://t.co/Eu77vAAk3N
TheDaoIndex KDAO2011 ( View Tweet)
Patients with acute calcium pyrophosphate arthritis at ⬆️risk of cardiovascular events. Abstr#1898 #ACR21 @RheumNow https://t.co/IOFYJnutHM
Richard Conway RichardPAConway ( View Tweet)
Why would higher active dose of #methotrexate with sc admin & more metabolites polyglutamates which can give side effects have LESS AEs? Never understood it! #ACR21 abst#1695 @RheumNow https://t.co/qrEKofX1cl
Janet Pope Janetbirdope ( View Tweet)
Abst1810 #acr21 @RheumNow survey of pt preferred meds for PsA points out ⬆️ interest in IL17 & PDE4 since 2018 guideline update: anti-IL17 compared to 2018 or earlier (30% vs 3.5% p< 0.001);anti-PDE4 (40% vs 11.5% p< 0.012). Meds SEs& prevention of joint damage important for pts
Olga Petryna DrPetryna ( View Tweet)
#ACR21 L16 - Breakthrough #COVID19 in rheum pts
⭐️Breakthrough ifn ~4%, compared to 3% wo rheum disease. Statistically signif ⬆️ risk in RA, gout, polymyositis, vasculitis, multiple rheum disease
⭐️bDMARD, multiple AIRD risks
@Rheumnow https://t.co/cuM9LcEr4u https://t.co/Los2n7BoIn
Links:
Eric Dein ericdeinmd ( View Tweet)
After 2018 ACR Guidelines, significant increase in IL-17i and PDE4i use in PsA pts
⭐️TNFi most common tx
⭐️28% pts not on any tx⭐️
#ACR21 @RheumNow Abs#1810
https://t.co/7Rmirfm3nK https://t.co/0Ui9pq5uyo
Links:
Robert B Chao, MD doctorRBC ( View Tweet)
RHEKISS registry: SpA pts on bDMARDs at conception are NOT at inc. risk for adverse pregnancy outcomes. Discontinuation of bDMARDs after conception is assoc'd w/ inc. dz activity during/after pregnancy & flare risk. Abs 1730 #ACR21 #RheumNow @RheumNow https://t.co/b2wI9GZios https://t.co/wsuvv3hF0v
Dr. Rachel Tate uptoTate ( View Tweet)
The plague protection genetically can lead to Pyrin induced inflammasome activation. Theory of more FMF in Mediterranean / Turkey. So high protection gene in population Dan Kastner - a genetic detective 9T119 #ACR21 #ACRBest @RheumNow https://t.co/qzdc12fT0j
Janet Pope Janetbirdope ( View Tweet)
In Phase 2 trial of Tildrakizumab in active PsA efficacy tended to be lower among patients with comorbid MetS, with improvements from baseline across efficacy measures generally larger in patients without MetS vs those with MetS @RheumNow #ACR21 Abst#1819 https://t.co/ATxaFz9X2O https://t.co/2iJMNmfUzg
Dr. Antoni Chan synovialjoints ( View Tweet)
Post hoc analysis of pooled data from 19 clin trials on SEC & CV risk & systemic #inflammation in PsO, PsA, AS
📌Traditional CV parameters remained stable on all SEC treated grps
📌SEC sig. ⬇hsCRP & NLR
@RheumNow #ACR21 abs1835 https://t.co/iCaGFbXNXn
sheila RHEUMarampa ( View Tweet)
French study shows more than 75% of RA/SpA pregnancies resulted in a live-birth, BUT 50% of pts had at least one unfavorable pregnancy outcome! However, miscarriage prevalence lower than in reported literature. Abs 1724 #ACR21 #RheumNow @RheumNow https://t.co/64PspIKPTu https://t.co/LyfHVARAgd
Dr. Rachel Tate uptoTate ( View Tweet)